The Dental Technician Magazine December 2019 by The Dental Technician Magazine

VO L 7 2 N O. 1 2 I D E C E M B E R 2 0 1 9 I B Y S U B S C R I P T I O N

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

MARKETING STRATEGIES IN 2020

PAGE 6

FACULTY OF DENTAL TRAINERS BECOMES BADN AFFILIATE PAGE 17

RELATIONSHIP BETWEEN DENTAL MATERIALS IN USE IN THE DIGITAL FIELD BY MATTEO NERONI PAGE 10, 12-13

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DIGITAL TECHNOLOGY COMPARISON OF GUIDED AND NON-GUIDED IMPLANT PLACEMENT ACCURACY PAGE 22

DTGB CASE STUDY BY ANDREW C WHEELER, OWNER OF AW PRECISION CERAMICS PAGE 20-21

YO BY UR R S A EC UB C O S SE OL MM CR E LE EN IPT PA A D IO G GU IN N E E G 3

DENTAL DORIS GIVE THOUGHTFUL GIFTS - DONÂ´T LEAVE IT UNTIL THE LAST MINUTE PAGE 8-9

Inside this month

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P.6

CONTENTS DECEMBER 2019

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

Welcome

Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com

Marketing

Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused. No part of this publication may be reproduced in any form without the express permission of the editor or the publisher.

Thoughts from the Editor

Marketing By Mike Bond

Insight 8-9

Dental Doris

Digital Technology Relationship between dental materials in use in the digital field Marginal and internal fit of pressed lithium disilicate inlays fabricated with milling, 3D printing, and conventional technologies Comparison of guided and non-guided implant placement accuracy

10, 12-13 13 22-23

Dental News New President of the BADN - Jacqui Elsden MSc FBADN Faculty of dental trainers becomes BADN affiliate Henry Schein Dental wins “Exceptional” Kent DWP Employer Award British Dental Association releases its 2019 manifesto Illegal Manufacture update Is there a link between Periodontal disease and Oral Cancer?

16 17 17 18 19 23

DTGB Andrew C Wheeler, AW Precision Ceramics

20-21

DTS 2020 DTS 2020is coming

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THOUGHTS FROM THE EDITOR

WELCOME to your magazine WELL, IT NEARLY IS CHRISTMAS!

I am sure the great majority of you are looking forward to a break from the pressure this time of year often brings. Last minute cases from those patients who cannot be denied and undoubtedly a few more before the break. There will be those cases that are far too complicated for the time scale and many others squeezed in just for Christmas. Looking back on the year it certainly has been full of interesting changes within technical dentistry and the changes are going on. Digital techniques are really being embraced by more and more laboratories both to change from traditional methods and to improve the work flow. We really have moved on and quality and quantity have been greatly influenced by the digital additions. Model making on a grand scale, as for Orthodontic cases is very much with us and many more techniques can, with the knowledge and skill of the experienced technician, be a real boon. Of course, some of the market materials and equipment will not produce the quality and load sharing as it should, but you as an expert should realise those selling to you at street level often will not know enough to make a real decision. Some of you will undoubtedly be sold equipment etc. which just does not fit the bill. Some of the shortcomings are clearly obvious so be aware and question whatever you are being offered. I will say that the number of knowing technicians is growing so before you lay out a lot of money or buy the wrong materials, talk with as many colleagues as possible. Don’t buy the first system offered and where you can find our who is using it and talk to them. We have spent far too many years and money by taking on something sold as the ultimate answer but find out too late it has shortcomings. There are inherent hurdles in digital techniques and when compared with the best of the traditional they struggle. You may find for instance that larger constructions cannot be made to fit in one piece as well as they should. I have no doubt there are those of you out there who will be creating and discovering methods to overcome the consequence of a “hands free” option. Why not raise a question around you query. And share it with the readership so we can create a national forum and discuss the actual

also be able to show they have attended a qualifying course in order to be sufficiently trained to undertake the task. So dental assistants and nurses are required to register with the MHRA as are dentists and CDTs. The sole purpose of registration was to ensure the patients safety, which must come first, and all registrants must ensure that situation.

situation within each digital offering. You could use the letters page and ask a pointed question! For the very affordable monthly price you could have access to a national forum for just these situations. Not just questions but perhaps tips and truths, just to stir the pot. Talk with your colleagues through the page of your magazine. Politically there are various discussions with government which may come to affect your work situation, whether you are all private or mixed or indeed all NHS. The BDA have come up with a new pricing structure to put before the Ministry and it will undoubtedly influence all areas of dentistry, including technology. Through Digital dentistry there is already a growing potential to avoid the use of Technical laboratories. The Clinician being the designer and manufacturer of the device. Well there will be outcomes some of which you will be able to use to your own advantage. My experience is that whatever they may claim 999% of Dentists cannot do the restorative work and make it look like teeth. In order to go direct they will be in the hands of the digital libraries and will soon learn they need some technical help. In order to protect the technical dentistry industry, we need the leaders of our representative organisations to stand up and be counted. The first step is to ensure that registration of all manufacturing is enforced, with unqualified assistants and associates on a formal learning pathway. The MDD, which will govern our workplace from 2020 states clearly that all manufacturers of dental devices designed for the patient must have at least 2 years, experience. They must

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How the system works is still a bit of a mystery and all my efforts to get answers from the GDC or The MHRA have been so far ignored. It would seem as if it is all too much trouble! I do intend to pursue the case as I really believe that registration should work on our behalf and not just be an expensive nuisance. The nuisance part is set to continue but It does seem as if Technicians find it almost impossible to work together for their common good. The DLA and the DTA, and the other named bodies need to realise we are sleep walking into situation which means no change for technicians, except expense and paperwork and all because they are too busy to really see the disadvantage of a registration system which does not work for the registrants. It does seem as if some people with other agendas are deliberately avoiding applying the various rules, such as the patient statement, and the MHRA registration. It does also seem as if illegal dentistry is being ignored except in the case of technicians. Technicians who have worked while not being registered were supplying cases to dentists who by using an unregistered laboratory were themselves working illegally. How many cases of dentists in this situation have you seen published, your right, NONE. So, the dentist can use an illegal source and probably not issue a patient statement, because there won’t be one. So illegal dentistry will continue and of course it will. You all know of people in your area who are operating like this. Why not begin to stop the rot. Contact your DT or DLA representative and ask for the organisations to raise the subject. If you know of dentists doing the same, report them. Unless we make our presence know, on these matters we will continue to be ignored.

Larry Browne, Editor

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MARKETING

MIKE BOND â&#x20AC;&#x201C; DENTAL MARKETING SPECIALIST MARKETING

l Mike is a self-employed marketing consultant who has worked

in the dental and healthcare sectors for over 25 years.

MARKETING STRATEGIES IN 2020

s we head in to 2020 I thought it might be useful to consider the idea that a marketing plan might be beneficial to most dental laboratories. In my experience most laboratory owners view success in its most basal format. All they want is the ability to earn a living while working for themselves (sorry for the generalisation!) and most desire a life that's replete with abundance in one fashion or another. Whether that's the abundance of time or money, it's a recurring theme that compels most to immerse themselves in the shackles of work, attempting to wield their dexterity and flesh out their ideas to generate an income. No matter what shape or form your lab has taken, without an effective strategy for marketing a business, success will seem fleeting at best. No matter how good a product or service might be, getting the proverbial word out is one of the most daunting tasks. Adding to the melee, having the wherewithal to grow and scale any business, established or new, takes an effective plan with clear and concise steps. It takes boiling things down to their basic and most fundamental elements, seeing what already works, and then implementing a strategy that will help you progress towards your goals over time. But how do you do it? How do you institute the right strategy to market a company, especially if you have an almost non-existent marketing budget as most labs do? Clearly, this isn't easy. It requires the fundamentals of a sound business that adds value to the world and looks to help others or solve a big problem first and foremost. WHAT IS A MARKETING STRATEGY? Any culmination of activities, whether online or offline, that helps a business to move closer to its short term or long-term strategic sales goals are part of its marketing strategy. It includes a thorough evaluation of the market dynamics, demographics and competitive environment of the industry to creating an overall plan of action. Overall, the plan is developed by not only scanning the external factors outside of the business, but also the internal factors as well.

are crucial to developing the right message and brand positioning to ensure success. TOP TIPS TO CREATE A GREAT MARKETING PLAN #1 Have a strong storyline - What do you or your laboratory stand for? What's the story behind it all?

This is often a prerequisite to determining both the opportunities in the marketplace, along with the threats that might exist from other opposing factors. However, beyond all the technical facets that might be involved in developing such a strategy and plan, being able to acutely understand where a business is right now, and how a laboratory can move the needle towards its goals is far more complex than it sounds. It's obvious that creating and executing an effective plan can be a difficult undertaking. DEVELOPING AN EFFECTIVE MARKETING PLAN Data and research are king in creating an effective marketing plan and it can be use ful to ask yourself these three questions to get a clear idea of your current business. 1. What's currently contributing the greatest amount to top-line sales 2. What's currently contributing the most to profit margin 3. What's currently contributing the most to sales growth velocity (what segments of existing products and services are growing the fastest) The answers to these questions when ranked in order can strongly point to certain key areas of the labs operations, and these can be optimised to speed up rapid or hyper growth. Additionally, it is vital to consider the principles that a business harbours which

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#2 Build a strong emotional attachment with your customers - Part of that bond is born from the storyline. But the other part is born by being transparent, honest and working to help solve a problem or fill a need, and ultimately providing immense amounts of value. #3 Be Consumer-centric by adding value Every strategy must place the consumer at the heart of the message #4 Be Multi-channelled and multi-platformed - You want to reach customers on different platforms such as Facebook and Adwords, for example, but also advertise to them on other channels like YouTube, Instagram and anywhere else they might congregate. #5 Think scalable - Any effective marketing strategy must be scalable - Small tests need to be done before doing a big ad spend. Once you have an offer that converts, you can scale that offer to infinity. #6 Remain agile - You have to be prepared to pivot your plan and be agile enough to move things around. Don't overcommit to something and be so entrenched that you're unable to pivot when necessary. #7 Leverage thought-leaders - Everyone's heard of influencer marketing. By getting the right thought-leader (advocate) on board, you can really take your marketing reach to the next level. Sam Walton, the iconic entrepreneur behind Walmart, once said that, "There is only one boss. The customer. And he can fire everybody in the company from the chairman on down, simply by spending his money somewhere else." The more your strategies adhere to this central principle, the more likely you'll be to succeed.

INSIGHT

WELCOME TO... DENTAL DORIS DENTAL DORIS HAS WORKED IN DENTISTRY FOR MANY YEARS AND LIKES TO MUSE ABOUT ALL KINDS OF DENTAL AND NON-DENTAL TOPICS

GIVE thoughtful Gifts

DONâ&#x20AC;&#x2122;T LEAVE IT UNTIL THE LAST MINUTE!

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It was recently my 6th wedding anniversary and according to those in the know for being married to my lovely husband for this length of time I need to give a wooden gift! Now he’s not really in to fruit bowls and we don’t have a garden so I racked my brains and decided a lovely bonsai tree would do the trick… small enough for a London flat, quite cute and he certainly seemed impressed! But now we all need to start thinking about Christmas! Giving gifts can be exciting, but at the same time challenging as ‘good gifting’ take thought. DON’T SHOP FOR YOURSELF As you are browsing for gifts in-store or online, you are inevitably going to be tempted to shop for gifts that you would love to receive. This instinct is completely understandable, but it is important for you to try to put yourself in the receiver’s shoes, rather than looking at things from your own perspective. A thoughtful gift is a relevant gift; one that reflects the recipients’ passions, loves, hobbies, and life. It is a gift that is the result of deep thought of the recipient and what would make him or her happy. It is NOT a gift that the gift giver would love to have, which is often the case. You might want to bring the recipient to a special place where you have memories together, or surprise them at home or at work. Remember, simply buying the most expensive gift you can afford is not always the best option. In fact, it may work against you. The gift should be something that the recipient would be pleased with – It doesn’t have to be a large, expensive gift. It is the thought that goes into the gift that’s much more important. START PLANNING IN ADVANCE Try to take time to think about the person you are giving the gift to and what they might like to receive. If you really have no

clue a carefully worded conversation might tip up some clues or arrange to go to a good quality store with the person and just browse and observe the things that they show interest in. As you try to come up with a thoughtful gift, you should consider all of the things that define the receiver. Naturally that is going to include hobbies, but there is so much more to a person than just what they do in their leisure time. A truly thoughtful gift often transcends what is clearly visible on the outside, showing the recipient that their inner qualities are recognised and appreciated.

INSIGHT

his month I thought I would try to give you some inspiration for the festive season and suggest a few ways to think about buying a gift for a loved one.

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EVERYONE ENJOYS FOOD When in doubt, go for a tasty treat! After all, nobody would be unhappy to receive a nice supply of their favourite treat. For instance, for the tea lover, a beautiful mug, assorted teas, local honey and tea biscuits. For the sports lover, a selection of craft beers, and snacks to enjoy while watching their favourite sporting event. The possibilities are endless! The fastest way to someone’s heart is through their stomach!” GIVE AN EXPERIENCE Sometimes the best gift isn’t a tangible object, but a memory. For instance, there’s no more meaningful way to honour someone than by treating them to an experience that reflects who they are: their personality, favourite hobby, a cherished milestone, fondest memory, bucket list wish, etc. And doing so can be equally as meaningful for the gift-giver, too - because there’s a good chance that the recipient of an unforgettable outing/adventure won’t soon forget who gave them something so unique. BE THOUGHTFUL When it comes down to it, giving a thoughtful gift takes just that – thought! Spend some time really thinking about what makes that special person in your life tick. Think about other aspects of the gift besides the gift itself, such as when you give it, where you give it, how you give it, and so on. Really think about why you are giving the gift, and then simply fill in the blanks from there… Good Luck and Happy Christmas!

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DIGTAL TECHNOLOGY

RELATIONSHIP BETWEEN DENTAL MATERIALS IN USE IN THE DIGITAL FIELD From: Matteo Neroni MATTEO NERONI

FIG 2

FIG 3

FIG 4 FIG 2: Upper Denture and Lower Zirconia all on 4. FIG 3-4: Zirkonia made ready for milling and veneering.

uring the period I ran the laboratory in Belfast, I often found the necessity to use different types of materials. Those in my opinion most suitable for the particuar restoration. Always looking for the best functional and aesthetic balance possible.

As was my normal practice, every case is taken through a detailed analysis of the physiognomy, facial conformity, vertical dimension and the relationship between the two jaws. Only then can the scanning and design be comleted with confidence and harmony with the patients needs.

The case, presented below, is the perfect example of how, when using four quite different types of materials, a harmony can be created with each different material providing the optional result for the case under construction. All coexisting side by side, without compromising aesthetics and function.

For the lower restoration an all on four design was chosen (fig.15). Using Zirconia veneered with composite. The maxilla did not have bone in sufficient quantities for Implants do s removable denture was the choice. Because of this mix of completely different u materials, the teeth chosen for the removable p. 12

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DIGTAL TECHNOLOGY

ucontinued from page 10 prosthesis were individual Zirconia millings made of Zirconium with Composite veneers for aesthetics withour creating the ceramic to ceramic occlusion. Certainly, this choice created a heavier restortion, so it was imperative the impression be of a very high quality. Following all the protocols the clinician took a very good impression and allowed us to obtain a perfect fit, with very good retentive suction. Thus creating a very stable and problem free prosthesis. Displacement resistant and with the chosen aesthetic result. (Figs. 18, 19, 20)

FIG 5

FIG 6

FIG 7

FIG 8

FIG 9

ABOVE FIGS 5, 6, 7, 8, 9: The step by step processes for scanning design and milling.

Regarding the lower rehabilitation (all on four), I adopted the same protocol developed and illustrated in the previous article in September. I left the composite part to my technical colleague, and he successfully balanced the material differences and created a very good match between the ceramic veneered upper teeth and the composite layerd Zirconia lower. Like every finalizer, I used some composite stains to mask the difference between the materials and I think I have succeeded.

FIG 11 FIG 12: MILLED ZIIRONIA ALL ON FOUR

FIG 10 FIG 13

Constructive criticisms, observations and different points of view are welcome for both the design and the finalisation of the restoration and its material choices. FIGS 10, 11, 12, 13, 9: Denture construction with milled Zicornia teeth. Milled Ziironia all on four. FIG 14: COMPOSITE VENEERS

FIG 15

FIG 17

FIG 16 ABOVE: Nothing more to say!

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DIGTAL TECHNOLOGY

FIG 18

FIG 19

FIG 20

FIG 21 HAPPY PATIENT RESULT

MARGINAL AND INTERNAL FIT OF PRESSED LITHIUM DISILICATE INLAYS FABRICATED WITH MILLING, 3D PRINTING, AND CONVENTIONAL TECHNOLOGIES Foudda R. Homsy, DCD, DESa I Mutlu Özcan, Dr Med Dent, PhDb IMarwan Khouryc I Zeina A.K. Majzoub, DCD, DMD, MScDd STATEMENT OF PROBLEM The subtractive and additive computer-aided design and computer-aided manufacturing (CAD-CAM) of lithium disilicate partial coverage restorations is poorly documented. PURPOSE The purpose of this in vitro study was to compare the marginal and internal fit accuracy of lithium disilicate glass-ceramic inlays fabricated with conventional, milled, and 3-dimensional (3D) printed wax patterns. MATERIAL AND METHODS A dentoform mandibular first molar was prepared for a mesio-occlusal ceramic inlay. Five groups of 15 inlays were obtained through conventional impression and manual wax pattern (group CICW);

conventional impression, laboratory scanning of the stone die, CAD-CAM milled wax blanks (group CIDW) or 3D printed wax patterns (group CI3DW); and scanning of the master preparation with intraoral scanner and CAD-CAM milled (group DSDW) or 3D printed wax patterns (group DS3DW). The same design was used to produce the wax patterns in the last 4 groups. The replica technique was used to measure marginal and internal adaptation by using stereomicroscopy. Mixed-model ANOVA was used to assess differences according to the groups and discrepancy location (α=.05). RESULTS Group DSDW showed the smallest marginal discrepancy (24.3 μm) compared with those of groups CICW

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(45.1 μm), CIDW (33.7 μm), CI3DW (39.8 μm), and DS3DW (39.7 μm) (P<.001). No statistically significant differences were detected among groups CICW, CIDW, CI3DW, and DS3DW relative to the marginal discrepancy. The internal discrepancy was significantly larger than the marginal discrepancy within all groups (P<.001). CONCLUSIONS Lithium disilicate glass-ceramic inlays produced from digital scans and subtractive milling of wax patterns resulted in better marginal and internal fit accuracy than either conventional impression/fabrication or additive 3D manufacturing. Three-dimensional printed wax patterns yielded fit values similar to those of the conventionally waxed inlays.

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EXTEND YOUR SUBSCRIPTION BY RECOMMENDING A COLLEAGUE There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge. At only £39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.

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DENTAL NEWS

NEW PRESIDENT OF THE BRITISH ASSOCIATION OF DENTAL NURSES (BADN): JACQUI ELSDEN MSC FBADN l The new President

of the UK’s professional association for dental nurses, the British Association of Dental Nurses (BADN), is Jacqui Elsden MSc FBADN

Jacqui qualified at Kings College Hospital Dental School in 1983 as a Dental Nurse, obtaining both the Hospital Qualification in Dental Nursing and the NEBDN National Certificate, and continued as a Senior Dental Nurse at Kings until 1984. Jacqui continued to work in general practice until 1988 when she took a three-year break to start a family, then continued in general practice until 2004. Since 2004, Jacqui has been employed by the postgraduate education and training arm of the NHS, formerly the Kent, Surrey and Sussex Deanery, now known as Health Education England London, Kent Surrey & Sussex (HEE LKSS). During this period, she obtained awards in Vocational Assessment, Internal Quality Assurance, Teaching and Mentoring together with Certificates in Practice Appraisal and Radiography. Jacqui has been an NEBDN examiner and was Chair of NEBDN’s QA committee from 2012-2017. Currently, Jacqui is part of the Reader Panel for the digital journal, BDJ

BADN is the UK’s professional association for dental nurses. Founded in 1940, membership is open to all dental nurses, working in all areas of dentistry; Full Membership (open to Registered Dental Nurses) is available with or without indemnity cover. Associate Membership is open to student, retired, former and overseas dental nurses. Benefits of membership include access to the members’ area of the website, the quarterly digital “British Dental Nurses’ Journal” with CPD, free legal and counselling

Team and a Professional Advisor for the GDC’s Registration Appeals Committee. Jacqui has an interest in research and has presented nationally at the Royal College of Surgeons of England and internationally at the Association of Dental Research in Barcelona and has been published in the dental press. More recently Jacqui obtained an MSc distinction in Advanced and Specialist Healthcare at the University of Kent and was awarded the annual Dissertation prize for the highest achievement. Jacqui continues her role with HEE LKSS as their Regional DCP Lead for Dental Nurses to commission post registration courses and hands-on training for GDC registered dental nurses across the region. Jacqui’s role also includes practice development visits to NHS primary care dental practices, regionally, to facilitate the ongoing development of the NHS workforce. Jacqui likes to spend time with her family when not at work. In addition, Jacqui is a keen gardener and enjoys relaxing on holidays wherever possible. Jacqui is a keen supporter of a local hospice and has participated in many fundraising activities over the years for Cancer charities.

helplines, a variety of special offers and discounts via BADN Rewards, as well as information and advice.

audited, and its annual accounts are published to members and by the Certification Office.

Members of the BADN Executive Committee are nominated and elected by BADN members, in accordance with current legislation, and serve a fixed term of office. The Executive Committee consists of the Chairman, President, President-elect/ Immediate Past President, Treasurer and Education Representative.

Photographs of the National Dental Nursing Conference 2019 are available on request.

BADN makes an annual return to the Certification Officer, is independently

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Pamela A. Swain MBA LCGI FIAM FCMI01253 338365 E: pam@badn.org.uk W: www.badn.org.uk

The UK’s professional association for dental nurses, the British Association of Dental Nurses (BADN), and the Royal College of Surgeons of Edinburgh’s Faculty of Dental Trainers are delighted to announce that the Faculty has become the Association’s latest Affiliate.

as valued members of the dental team, and to interact with dental nurses in exactly the same manner as with other dental professionals. Affiliates receive access to the BADN website and quarterly digital “British Dental Nurses’ Journal”, as well as an entry on the website www.badn.org.uk and special promotion opportunities.

The Affiliate scheme was set up by the Association to encourage closer links between BADN members, other dental organisations and dental industry companies. Affiliates may use the Association’s Affiliate logo (pictured above) to show that they are dental-nurse friendly, having agreed to recognise dental nurses

BADN Immediate Past President Hazel Coey said “We are delighted that the Faculty of Dental Trainers has decided to become a BADN Affiliate. BADN has close links with the Royal College of Surgeons of Edinburgh through its DCP Advisory Board, and now with the Faculty of Dental Trainers; and we encourage

DENTAL NEWS

FACULTY OF DENTAL TRAINERS BECOMES BADN AFFILIATE anyone involved in dental nurse training in the UK to consider joining the Faculty.” Dr Sarah Manton, Director of the Faculty of Dental Trainers, said: “This is a positive step for the Faculty that really demonstrates our commitment to the dental team Our role is to provide support and guidance for all dental trainers and by creating strong links with key partners such as the BADN, we can work together to continually improve standards in training and to ensure patient safety.” Information on the Affiliate scheme is available from BADN Chief Executive Pam Swain at pam@badn.org.uk

HENRY SCHEIN DENTAL WINS “EXCEPTIONAL” KENT DWP EMPLOYER AWARD

Henry Schein Dental is delighted to have won an Employer Award at the Kent Department of Work and Pensions (DWP) Employer Awards ceremony. The awards celebrate the support that employers give to people who require extra help entering the workforce, including young people with special educational needs and disabilities (SEND).

Ashley Doe proudly shows off the Award

Henry Schein Dental received this acknowledgement in recognition of the Supported Internship programme that it has established with Bradfields Academy, a local school catering for SEND youngsters mainly within the Medway area of Kent. Galvanised by the shocking statistic that only 6% of the current adult working population with SEND find employment, the scheme saw three students from Bradfields employed at Henry Schein’s Gillingham-based warehouse in September 2018.

to gain experience and were supported throughout by an in-house job coach. They also spent one day off site working towards English and Maths GCSE qualifications. At the end of a successful year, two of the internees were offered full-time employment with Henry Schein, and four new students are interning with the company for what everyone hopes will be a second promising year. The scheme was awarded ‘Exceptional’, the highest level in the Schools Support category of the Awards at an event held at Grosvenor Hall in Ashford and attended by outbound supervisor for operations at the Henry Schein warehouse, Ashley Doe, who said, “It’s fantastic to be recognised in this way. The instant success of our internship scheme has shown us just what is achievable, and we are looking forward to seeing our new group of interns flourish.” CONTACT: www.bradfieldsacademy.co.uk www.henryschein.co.uk

The students worked in the warehouse, spending time in different departments

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BY DENTAL TRIBUNE INTERNATIONAL I NOVEMBER 19, 2019 LONDON, UK: The British Dental Association (BDA) has launched its 2019 manifesto, just prior to the upcoming general election. In the document, the trade union calls for politicians from all parties to cease overlooking oral health and to instead recognise it as an integral part of overall health policy. The manifesto sets out the BDA’s key priorities for the next UK Parliament, which include: • an NHS dental workforce that is given the support and incentives necessary to encourage long-term commitment; • the removal of barriers to patient care through a long-term funding solution for NHS dentistry; and • an emphasis on prevention, and not just treatment, by tackling oral health inequalities. The UK is set to withdraw from the European Union on 31 January 2020 as part of the ongoing Brexit negotiations, and a significant impact on the nation’s dental

Mick Armstrong, Chair of the BDA’s Principal Executive Committee. “We need a joined-up approach to prioritise the nation’s oral health. Tooth decay and gum disease are the most prevalent - but preventable - diseases in Britain. Oral health is key to overall health, and dentistry cannot remain in a silo,” he continued.

workforce is expected. As reported by Dental Tribune UK and Ireland earlier this year, 32% of dental professionals who qualified in the European Economic Area, but currently work in the UK, intend to leave the UK within the next few years. Half of these respondents cited Brexit as the driver of this decision.

“The oral health gap between rich and poor isn’t closing, patients are struggling to secure access, and the service faces a mounting recruitment and retention crisis. This document doesn’t just cover our concerns for the next four weeks of campaigning. It reflects our belief that real progress will require the next government to look at the workforce, funding and public health together,” Armstrong concluded.

“Our message to politicians of all parties is that oral health can no longer be the missing piece in health planning and budgets,” said Dr

The document, titled The Missing Piece: The BDA’s Manifesto for Oral Health 2019, is available to view or download free of charge.

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DENTAL NEWS

BRITISH DENTAL ASSOCIATION RELEASES ITS 2019 MANIFESTO

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Made in England

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ILLEGAL (?) DENTAL DEVICE IMPORTER REPORTED TO THE TO THE MHRA After the article a few months ago in The Dental Technician about the cases of suspected illegal manufacture in the UK raised by The Dental Technician with the GDC, a technician has written to the Editor of The Dental Technician saying that they have done the same, but this time reporting what looks like an illegal importer to the MHRA. The Technician (who gave permission to publish) says that they became aware of a highprofile dental laboratory that they believe is importing dental devices from abroad. “I spent a fair while searching the MHRA website for any company registered under their name or at their business address, but to no avail. From here, I decided to email the MHRA to request the laboratories registration details.” The technician says they checked the MHRA website and found that the Laboratory was then showing first registration a few days after the complaint. They suggest that they had been illegally importing for several years. They also believe that the Laboratory is being run by GDC registered technicians and go on to say “Given the recent palaver with the MHRA registration moving online and having to resubmit registration details and updating devices made it seems even more ridiculous that labs remain unregistered with no comeback. Once again, those that are trying to meet regulatory requirements spent a lot of time and effort moving over to the new system with next to no help or information from the MHRA. Seemingly a time consuming 'box

ticking' exercise with no benefit to anyone if labs are still practicing unregistered anyway.” If this business was not registered these technicians were committing a criminal offence, and multiple breaches of GDC standards. They may have also broken the law over patient information. The dentists using them were involved with illegal activity in treating their patients. Why did they do it? Why were dentists using them? Have the MHRA reported this case to the GDC? What action will the GDC take? Will the GDC and the profession find out at fitness to practice why they chose to break the law? It is not in patients’ interest to be involved in illegal activity that may also invalidate a dentist’s indemnity insurance. This technician is right, with most dental technicians required to have DAMAS auditing with a compulsory requirement to join the DLA before they can be audited at a total cost of hundreds of pounds, what place does illegal manufacturing have? DTA URGE TECHNICIANS TO REPORT ILLEGAL MANUFACTURING ACTIVITY A few months ago, the DTA published guidance to its members, urging dental technicians to report illegal manufacturing activity by GDC registrants to the GDC. (The Dental Technician asks, what is the process if technicians do?) It is a coincidence that this is what the Editor of The Dental Technician (an ex GDC registered technician) has done with 5

THE KINGSHOLM GROUP (DLA, DTA, OTA, DAMAS AND THE DENTAL TECHNICIAN) SET TO GET ANSWERS The Dental Technician has carried out considerable research to see how the medical device regulation is implemented in dentistry. The answers from the MHRA and GDC caused concern and seem to point to a regulatory gap. The information, letters and examples were given to the above groups who have all assembled under the Kingsholm group. (It is named after the Kingsholm stadium in Gloucester where the DTA hosted the first meeting). The Dental Technician also raised concerns over the education of nurses and dentists. At the initial meeting some members focused on education. While you can never have enough, it does not deal with people who knowingly manufacture illegally or use illegal importers because they can do so unchallenged. The Dental Technician was happy that two of the action points agreed could directly deal with this problem, one being to examine the exchange of data between the GDC and MHRA. In order to do this The Dental Technician has tried for a second time to get a full account of how the GDC and MHRA work together and how illegal activity is dealt with so it can be given to the group. Again, without success. The group has been made aware of this. The DLA has agreed to host the next meeting in Nottingham where the outstanding action points will be discussed. The DT will want to discuss the cases reported to the GDC and MHRA. Readers may wonder how many complaints made by patients about dental devices are the result of illegal manufacture under current regulation and how is it possible? The Dental Technician will try and find out.

TO ADVERTISE IN THE DENTAL TECHNICIAN T: 01372 897 462 E: sales@dentaltechnician.org.uk

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DENTAL NEWS

ILLEGAL MANUFACTURE UPDATE

manufacturers who appear to not be on the MHRA web database. They were reported to the GDC. The Dental Technician reported that answers had been sought from the GDC on how the investigations were conducted and how the GDC shared data with the MHRA. No answers were received.

DTGB

INTRODUCTION l These are interesting times, we see the rise of the digital work flow

combined with skills that have been honed over generations of dental technicians. Neither option can be used entirely on their own, our skills are vital if we are to deliver the patients and clinicians expectations. I aim to demonstrate how this can be accomplished on a challenging case we received recently. We will endeavour to highlight the positive and negative areas of ways of working in both fields. As in most cases we see, there are always compromises one has to make, both from the clinical side and from the patient. Making the best possible outcome is something we all strive for within those limitations, and in some areas having a digital solution goes a long way to help. However, twenty years of the analogue approach is hard to dismiss and as we shall see, on occasion using a pair of hands, rather than a machine is a much better way forward!

ANDREW C WHEELER OWNER OF AW PRECISION CERAMICS

Andrew started his apprenticeship aged 17 at G Randals Dental Laboratories, after qualifying he moved to South Africa to further his education. Here he specialized in implants, frame design and other aspects of crown and bridge. After six years he returned to the UK to help open and run a large commercial laboratory. He moved to open his own laboratory 15 years ago dealing with large complex implant restorations and that led to his digital journey. By investing in 3d printing early on in the industry he gain valuable insight into the future of dental laboratories and where they were heading. As well as running his lab he also lectures and teaches digital solutions within dental laboratories.

HISTORY

This 55-year-old male patient presented with numerous dental problems with the desire to improve function and aesthetics. The patient had implants placed overseas in the upper right quadrant some years ago, in combination with a removable partial denture. He has struggled over many years with a badly fitting denture and expressed a desire to have something more permanent. As with many patients he had a history of patchwork dentistry, good and bad, trust in the dental profession was at an all-time low.

TREATMENT PLAN

It was decided that eight Ankylos not as shown implants would be placed in the anterior and posterior regions. Crowns would be placed on the canines and once these had been restored, we would remove his existing bridge and restore the right quadrant. This would maintain his occlusion as the restorative work was being carried out. The upper left eight will be left alone. His occlusion is stable and he has no pain or discomfort, one of the reasons for restoring in sections. The implants have integrated and the next step is too fit the abutments and crowns before preparing the canines and removing the existing implant bridge. We discussed with the patient the choice of materials and settled on zirconia abutments in the anterior region with all ceramic, Celtra press crowns. Posterior would be titanium abutments with cemented bonded crowns. All the abutments would be sent to Atlantis to mill.

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DTGB

LAB PROCEDURE

After the alginate impression were taken, we constructed a wax bite and special tray for the final implant impression. Models were cast and the case was articulated. This is when the digital side of the work started and one which has made a technicianâ&#x20AC;&#x2122;s life mush easier. In the past we would now be ordering semiprecious UCLA abutments to be waxed, milled and cast, a very time-consuming procedure. We scroll forward and now we have a range of scanners and milling centres that are as good producing highly accurate and cost-effective implant components. Our job is now to provide them with the right information to do the job. I have been using Medit scanners for many years and have found them to be an accurate, fast and reliable machines. Thanks to an evolving market some of the improvements have been real time savers. In the past one would have to order many scan markers for a case like this but now we have the flexible die feature we can use one marker and scan each implant site, moving the marker each time. A very costeffective way of working. As you can see from the picture, we are halfway through the scan with whole model taking no more than thirty minutes to complete. As this scan is being sent to Atlantis, we have no extra design time to add on as they design the abutments and send a series of pictures for you to adjust and change as you see fit. Having extols the virtues of the digital procedure I donâ&#x20AC;&#x2122;t use the core file option of Atlantis. This allows you to download

the finished abutments so you can start work on the digital design of the crown and bridge work. This useful idea can save a considerable amount of time if you plan to mill or print the crowns for pressing. However old habits die hard, I do like to double check the position and emergency profile of the abutments before I start the

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next stage. Adjusting the finishing line of an abutment is something I do regularly.

CONCLUSION

In part two I will complete the restorative part of the case, by digitally designing, printing and hand finishing the crowns.

DIGTAL TECHNOLOGY

COMPARISON OF GUIDED AND NON-GUIDED IMPLANT PLACEMENT ACCURACY

PART ONE

By Dr Ĺ ukasz Zadrozny I June 26, 2019 The procedure of implantation is becoming an increasingly popular method for replacing teeth. The critical factor in the achievement of a therapeutic and aesthetic long-term effect is the accuracy and precision of implant placement, being the support for the future prosthetic work. Thanks to modern digital technologies, it is possible to plan the implantation virtually. Evaluation of this plan by 3D printing in a subsequent step allows the creation of implant guides. Using the guides, which provide precise information on implant placement and insertion depth and angle, allows the maintenance of all the parameters included in the planning stage, lowering the risk of a mistake during implantation. Using 3D printing allows the fabrication of both implant guides and it possible to compare the precision of procedures under the in vitro conditions, which are safe and representative of actual requirements. During the implantation, clinical conditions very often hinder precise orientation in the operating field, thus the precision of implant positioning is lower. According to the literature, both more and less experienced clinicians face this problem. Introducing virtual planning based on CBCT is highly useful while preparing for the procedure; however, what allows the fully controlled preparation of the implantation site is the transfer of its result to the guide imposing the positioning. The virtually created implant guide can be printed using a 3D printer, sterilised and then used in the procedure. The use of the guide affects the precision of the procedure and shortens its time. AIM OF THE STUDY The aim of the study is to prepare 3D models for the analysis of the precision of implant procedures performed on the basis of digital planning, conducted with and without the use of implant guides.

Fig 1

ABOVE: Dr Ĺ ukasz Zadrozny

Fig 2

Fig 3 A Fig 3 B

Fig 6

Fig 4

Fig 5

FIG. 1A: Virtual planning of implant positioning. FIG. 2: Exemplary pair of models before the procedure: on the left, without the guide, and on the right, with the guide. FIG. 3 (A AND B): A model with the guide and implants after the implantation. The guide was stabilised with two posts. FIG. 4: The material was deposited on the drill attached to the extension. FIG. 5: Drill attached to the extension passing through the reduction sleeve. The extension allows the drill to be guided correctly without touching the template on the adjacent tooth with the contra-angle handpiece. Clinically, the use of the drill extension may be impossible, especially in molars, owing to the limited opening of the jaws. FIG. 6: Models after performing the procedures with the use of the guide. The same of the implants inserted are visi

METHODOLOGY Based on the CBCT examination of the patient, who underwent implantation in the mandible, a 3D model corresponding to the actual bone and mucosal conditions before implantation was created in DDS-Pro

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software (www.dds-pro.com.pl). It was then reprinted 20 times. The print was produced with selective laser sintering technology using polyamide powder in the TPM Elite P3600 SLS System printer (Solveere). It yielded ten identical pairs of mandibular models. Virtual

FINDINGS The use of 3D printed models allows implantation under conditions spatially corresponding to those of a clinical situation. However, the models printed in this study were hard. The material cut during osteotomy preparation was deposited on the drill and the implant thread, making it difficult to perform full-depth insertion. More torque was required to insert the implant than is clinically used. It was observed that, when an osteotomy was prepared in the vicinity of a preserved tooth, there was a need to use the drill extension in order to avoid leaning the contra-angle handpiece on the guide or tooth. Because this tool is missing in the OsstemGuide KIT(Taper), one must have an additional implant kit when using it clinically. The use of the guide shortens the implantation time, compared with the same procedure performed with no help of a guide.

In the following stage of the project, the models will be optically scanned and undergo comparative analysis in terms of repeatability, accuracy and compliance with the planned virtual goal.

The study is being carried out as a part of a project in the field of scientific developmental research aimed at the development of young scientists and students enrolled in PhD studies, financed as part of the scientific activity of the Medical University of Warsaw in Poland. This article was published in CAD/ CAM - international magazine of digital dentistry No. 01/2019.

The research is being led by Dr Louise Belfield, a lecturer in biomedical science at the University of Plymouth’s Peninsula Dental School, in collaboration with the university’s Institute of Translational and Stratified Medicine. Since cancer requires blood vessels to grow and metastasise, the research team is planning to build on existing evidence that shows how certain bacteria that cause periodontal disease are linked to angiogenesis. To do so, the research team will develop miniature tumours and blood vessels in a laboratory setting, adding the bacteria with the aim of clarifying how they function and what effect they have on the blood vessels. According to a press release from the university, if the research ascertains that the bacteria make the blood vessels grow more rapidly and similarly to those associated with tumours and identifies the process by which this is achieved, the results

DENTAL NEWS

IS THERE A LINK BETWEEN PERIODONTAL DISEASE AND ORAL CANCER? PLYMOUTH, UK: As worldwide oral cancer rates continue to climb, our understanding of what causes the disease to occur, thankfully, also continues to grow. Tobacco use and excessive alcohol consumption have been established as primary risk factors, and researchers are now investigating another potential source for this condition: the bacteria that cause periodontal disease.

exactly how the bacteria affect tumour and vessel growth yet,” said Belfield. “The bacteria may not cause the cancer, but they may do something to make the progression of the cancer speed up. One way they could do this is via the blood vessels, encouraging them to grow more rapidly or in a way which helps the tumour to grow. So if we find out what this is and how it works, it can help us develop and put screening processes in place to detect and reduce the numbers of those bacteria,” she continued.

ABOVE: Dr Louise Belfield presents her planned research at an event organised by the Oral and Dental Research Trust. (IMAGE: UNIVERSITY OF PLYMOUTH)

could form the basis of a new screening programme to detect oral cancer risk earlier. This would make it possible to begin treatment in a more timely manner. “We know that tumours in the mouth, unlike many other tumours, are in constant contact with bacteria, but we don’t know

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DIGTAL TECHNOLOGY

planning ( DDS-Pro; Fig. 1) of implant positioning and placement (TSIII, OSSTEM IMPLANT) and the implant guide, printed in 3D with Jet technology (ProJet MP 3000 printer, 3D Systems), with stock sleeves for three implants with regular platforms previously used clinically (sterilised), were used to introduce implants into every second printed model, using the OsstemGuide KIT(Taper). The drilling speed was set at 1,200 rpm. Water cooling was not used. Osteotomies were performed according to the manufacturer’s instructions. Other models were used for implantation based on the planning performed, but without additional help (no guide), using the same implant kit and under the same conditions. As the test was conducted in vitro, TSIII training implants with dimensions of 4 × 10 mm were used. It was assumed that all ten procedures performed would yield the same results.

Dental Tribune International (DTI) has previously reported on a study which confirmed the crucial role of dental professionals in detecting oral cancer early. This early detection can greatly improve the prognosis of sufferers. “Oral cancer is a horrific disease with poor survival rates—only around 50% of those diagnosed are alive five years later. It is an inyour-face, no-hiding, disfiguring disease, and the treatment can be very protracted, complex and costly,” said Dr David Conway, Professor of Dental Public Health at the University of Glasgow’s School of Medicine, Dentistry and Nursing, in an interview with DTI last year. “The earlier it is detected, however, the better the outcome can be,” Conway added

DTS 2020

DTS 2020 IS COMING DON´T MISS THE BIG ONE

IT’S TIME TO GO DIGITAL

It’s no secret that dentistry is going digital. Indeed, many businesses have already gone digital and are reaping the rewards of doing so. These technologies offer an array of tangible advantages that ultimately benefit dental labs, dental practices and patients. The key is to find the right solutions for the business and to maximise on the value afforded by those solutions.

IMPROVING EFFICIENCY

Digital technology affords several benefits for dental labs. For a start, it makes routine processes quicker and easier for greater efficiency and productivity among technicians. Digital equipment also achieves all this without any compromise in quality of the solutions being produced in the laboratory. In fact, in many cases, cutting-edge technology can improve the accuracy of products and the predictability of the manufacturing process for better results than would otherwise be achieved with analogue techniques.

STRENGTHENING RELATIONSHIPS Combining all of these benefits helps to ensure that an exceptional service is provided to clinicians every time. Not only does this keep existing clients happy, but it also increases the chance that they will recommend the laboratory to others, improving the business’ reputation, boosting profitability and encouraging growth. Another huge advantage of digital technology is its ability to enhance communication between lab and practice. Web-based solutions enable the transfer of information between technician and dentist in a matter of seconds – a far cry from the postal services of yesteryear for lab tickets. The immediate interaction allows technicians and dentists to discuss

cases and collaborate more closely, making way for greater versatility in the workflow. Not only does this strengthen professional relationships, but it also provides better treatment outcomes for patients.

OVERCOMING THE CHALLENGES

There are only two downsides that may prevent some dental labs from going digital. The first is the initial upfront cost of purchasing the equipment. The second is the learning curve faced by dental technicians in order to master the new technology and take advantage of all its abilities. However, these can be minimised and overcome with careful product selection. For example, many technology suppliers now offer payment plans or rental schemes that significantly reduce the initial financial outlay involved when introducing new innovations into the lab. These make a wide range of technologies more affordable for more laboratories, even smaller businesses that need to be more careful with their cashflow. As for the learning curve faced by dental technicians, this is unavoidable if the team is to really understand how the technology works and how it improves their work. Nevertheless, it is possible to shorten the curve by sourcing high quality training and on-going support from the manufacturer or supplier. Ensuring these elements are included in the initial purchase package will provide peace of mind that all possible hurdles are prepared for.

LOOK FOR VALUE

So how do you choose the right technologies for your laboratory? Ultimately, it’s about focusing on the value of the equipment you're considering, rather than the initial cost. If a solution has the

potential to shorten turnaround times while simultaneously improving the accuracy of products made, then the return on your investment will make the purchase very worthwhile. Equally, if you need to update your equipment in order to better compete with another lab that already offers a digital workflow, you will lose far more in the longrun if you don’t make the leap now.

FIND IT AT DTS 2020

If you’re looking for digital, quality and value, look no further than the Dental Technology Showcase (DTS) 2020. The event will host an array of manufacturers and suppliers of digital dental technologies from 3D printers to the latest CAD/CAM software and equipment. Throughout both the trade floor and educational programme, we will be exploring how digital technologies improve the dentisttechnician relationship and the quality of patient care. We will also highlight the value of investing in various technologies for labs of different sizes and focuses. Completely free for delegates to attend – with hours of enhanced CPD, showonly promotions and every opportunity to network with like-minded professionals – DTS 2020 is not an event to miss! Further still, we have partnered with MediFinance to offer delegates bespoke payment plans that make the purchase of important technologies more affordable.

ADOPTING DIGITAL

While there are a couple of hurdles to overcome when looking to adopt new digital technologies, these are nothing compared to the benefits available when you choose wisely. By searching for value in technology, every dental laboratory can reap the rewards of digital.

DTS 2020 WILL BE HELD ON FRIDAY 15TH AND SATURDAY 16TH MAY AT THE NEC IN BIRMINGHAM, CO-LOCATED WITH THE BRITISH DENTAL CONFERENCE AND DENTISTRY SHOW. For more information please visit www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE SHOFU:EXCELLENT RESULTS WITH LITTLE EFFORT “PFM RESTORATIONS – ANYTHING BUT OUTDATED” w German Bär, dental technician and veneering specialist of Dental-Team Sankt Augustin, Germany, tested Shofu’s metal-bonded porcelain system Vintage PRO before its launch at the 2017 International Dental Show (IDS). It is now an integral part of the production processes in his laboratory. One year and many PFM restorations later, he shares his experience. When browsing dental journals, we might think that today PFM restorations play only a minor role in the everyday work of dental technicians. Reality is different: Due to increasing cost awareness of and decreasing payments from statutory health insurances, dental laboratories increasingly use nonprecious alloys for standard PFMs. However, customers and patients have not lowered their aes-thetic demands as a result of these cost-cutting measures – quite the contrary. To meet the demands, we need modern buildup porcelains that are not prone to greyish or greenish discoloration but natural-looking even on nonprecious alloys. Patients expect their PFMs to be more or less as aesthetic as all-ceramic restorations. For dental technicians, it is important to achieve this challenging goal with little effort. PFM vs. All-Ceramic: Advantages of the Classic Approach In my view, the use of PFM restorations in dentistry is comparable to the use of concrete in construction, which is also often frowned upon: It depends on what you make of it. In cases with difficult statics, e.g. when interocclusal distances are short or long-span bridges are necessary, I still prefer PFM to all-ceramic solutions – if only for reasons of longevity and safety. Vintage PRO closely matches the VITA Shade Guide, which I regard as a great benefit. If the VITA shade has been correctly selected, I can be sure that my re-sult will accurately match the tooth shade. Meaning: When I build up A3, I will get A3. Even if the porcelain has to be fired more often than usual, it will not become greyish but show high shade stability. Besides, the appearance will come close to that of an all-ceramic even when using normal layer thicknesses. Promoting dental materials as “easy to use” is one thing; keeping this promise is another. Vintage PRO has really met our expectations in practical use: This build-up porcelain can be used not only by experienced technicians, but also by new-comers and ambitious trainees. The materials are highly stackable during layering and very easy to sculpt with some practice. Moreover, the porcelain shows only minimal firing shrinkage. The details I create during

layering will still be there after firing. This allows users to experience great success, especially if they are beginners. And the Effect and Gum shades help experienced dental technicians to easily, safely and efficiently fabricate even the most complicated large-scale restorations and demanding anterior teeth. Vintage PRO can be recommended to all technicians wishing to achieve excellent results with little effort. By the way, the system can also be successfully used for indications not included in the manufacturer’s IFU. We used it to build up veneers on refractory dies. The results were great. When there is no metal framework, lifelike light effects will be especially well visible. We were also very happy with the natural opalescence of the Effect and Incisal shades. The benefits of Vintage PRO have made everyday work much easier for us. Anterior and posterior crowns and bridges can now be efficiently veneered. Posterior crowns can be made in the “one bake technique” with some practice. The efficiency of this technique is virtually unbeatable: One layering step, one firing step, and that’s it. And even aesthetics leave nothing to be desired. Let’s take a look at the fabrica-tion of anterior single crowns, a dental technician’s core competence: To naturally and harmoniously match a crown to the adjacent teeth in terms of shade and all the other characteristics, I must be able to precisely control the opalescence and fluorescence of my porcelain. Vintage PRO allows me to optimally achieve the opalescent light refraction and brilliant shade effect desired. Shofu was the first manufacturer to introduce the interplay of light between fluorescent dentin and opalescent enamel into dental porcelains. This phenomenon is particularly well visible in reflected and transmitted light. Vintage PRO benefits from Shofu’s years of experience in every respect. Equipped for All Situations: Comprehensive Assortments We have thoroughly tested all Vintage PRO assortments with all porcelains available, including Body, Effect and Gum, in cooperation with clinicians. Our conclu-sion: Vintage PRO has definitely proved itself. This porcelain system helps us to fully satisfy both patients and customers.

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To colleagues who wish to excel in their work and go beyond standard PFM layer-ing, I recommend the shades of the Enamel Effect Set. And when fabricating large, implant-supported bridgework, the Gum shades will be essential. Like all experi-enced technicians, I have developed my own preferences; I like to work with the Body porcelains, not least because they closely match the VITA shades. Besides, I highly appreciate Effect and Opal with their natural opalescence. The Challenge: PFMs and All-Ceramics Side by Side Frequently, patients receive all-ceramic anterior restorations and PFM posterior restorations. These cases are not always easy to handle. However, Vintage PRO proves very useful here, since it conducts light virtually like all-ceramic restora-tions. With little effort, transitions can be concealed even when using a normal layer thickness, so that they are no problem for technicians and not recognisable in the patient’s mouth. The transition from anterior to posterior teeth can be incon-spicuous and harmonious, because canines are often more chromatic. Even when handling a material that is essentially easy to use, a few basic points should be observed. In the case of a metal-bonded porcelain system, first of all, the coefficient of thermal expansion (CTE) of the metal framework deserves clos-er attention. Vintage PRO is designed for a firing temperature of approx. 900°C. The firing schedule included in the IFU is primarily geared to nonprecious alloy frameworks, regardless of whether they are traditionally cast, made by CAD/CAM or sintered. When veneering these alloys, long-term cooling may be beneficial. When veneering high-gold or reduced-gold alloys, long-term cooling may or may not be advisable, depending on the CTE. My Tip for Colleagues: Try Something New I can really recommend giving Vintage PRO a try – e.g. the Incisal porcelains with their beautiful transparency. Or why not mix Incisal with some Opal-OC for more diffuse light refraction? There are so many ways to use this versatile porcelain system to your advantage. Just remember: Practice makes perfect.

FREE VERIFIABLE ECPD As before if you wish to submit your ECPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge. This will be less than the CPD submitted by post. This offer is open to our subscribers only. To go directly to the ECPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd. You will normally have one month from the date you receive your magazine before being able to submit your ECPD either online or by post. If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk

4 Hours Verifiable ECPD in this issue LEARNING AIM

The questions are designed to help dental professionals keep up to date with best practice by reading articles in the present journal covering Clinical, Technical, Business, Personal development and related topics, and checking that this information has been retained and understood.

LEARNING OBJECTIVES REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management

LEARNING OUTCOME

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Correct answers from November DT Edition:

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VERIFIABLE ECPD - DECEMBER 2019 1. Your details First Name: .............................................. Last Name: ........................................................Title:................ Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:............................................... Telephone: ......................................................Email: .................................................. GDC No:.................. 2. Your answers. Tick the boxes you consider correct. It may be more than one. Question 1

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Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852 You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN MIKE BOND MARKETING Q1. What does Mike Bond recommend for marketing success? A. Cheaper prices. B. Marketing strategy. C. Better delivery boxes. D. A Christmas Card. Q2. What does he rate as No.2 in the marketing plan? A. The best-selling product. B. The fastest growing product. C. The Most profitable product. D. Packaging. Q3 A. B. C. D.

What is the no 3 top tip? Be consumer centric. Have a strong story line. Be multi-channelled. Remain agile.

Q4. A. B. C. D.

Who does Sam Watson say is the ultimate boss? The Sales Director. The Chairman. The Customer The Boss’s wife.

RELATIONSHIP BETWEEN MATERIALS USED IN THE DIGITAL FIELD Q5. What were the materials used by Matteo in his example? A. Titanium. Acrylic, Zirconia and Composite. B. Zirconia, Acrylic, Composite, and Spinell. C. Zirconia, Acrylic, Composite and Ceramic D. Acrylic, Composite, Co-Chrome Zirconia. Q6. A. B. C. D.

What is the second mentioned requirement for all cases? Vertical Dimension. Facial Conformity. Jaw relationship. Smile Line.

Q7. A. B. C. D.

How many implants were placed in the maxilla? 6 Implants. 4 Implants. 2 Implants. No Implants.

THE MERIT AWARD SCHEME FEATURED CASE Q8. What type of implants were selected? A. Astra. B. Ankylos. C. Atlantis. D. Core-vent.

Q9. What are the anterior crowns made from? A. Zirconia. B. Porcelain fused to metal. C. Zirconia with ceramic crowns attached. D. Zirconia with Composite veneers. Q10. How many implants were placed? A. Four. B. Six. C. Five. D. Eight. Q11. A. B. C. D.

What restorations were made first? Posterior right quadrant bridgework. Anterior crowns. Canine crowns. All implant borne crowns.

Q12. How many upper teeth were not altered in the reconstruction.? A. 4 Teeth. B. 6 teeth. C. 5 teeth. D. 7 teeth Q13. Which part of the Atlantis system does Andrew choose not to use? A The metal abutment scan. B. The Zirconia abutment scan. C. The Core file. D. The Occlusal capture scan. HENRY SCHEIN AWARD WINNER Q14. For which disability was Henry Schein’s exceptional award given? A. Downs Syndrome. B. Motor Neuron Disease. C. Special Educational Needs and Disability (SEND). D. Word blindness. VIRTUAL PLANNING RESEARCH PROJECT Q15. How many implants were chosen for the study? A. Eight. B. Six. C. Three. D. Seven Q16. A. B. C. D.

What is the purpose of the study? To avoid using impressions for study models. To compare the Traditional and Virtual for accuracy. To Change the method of approach to safe placement. To discover if you need to plan at all.

You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE KEMDENT: INTRODUCING KEMDENT’S ORTHODONTIC GLITTER ACRYLICS! w NEW! Glitter acrylics to add sparkle to your orthodontic appliances, very popular with younger patients. Kemdent Orthodontic powder is a selfcuring acrylic which allows easy construction of orthodontic appliances using the ‘salt and pepper’ method. Choose from 6 exceptional colours or take up our introductory offer of buying 6 and receiving a 150ml liquid free. Visit www.kemdent.co.uk for more information or contact us at 01793 700 256 for our discount offers.

SAVE TIME AND MONEY WITH KEMDENT LIGHT CURE TRAYS w During December, buy more and save more on Kemdent Light Cure Trays. Buy 5 x 50/box Light Cure Trays for only £29.25 + VAT each. RRP £39.00+VAT. The trays are available in Pink or Aqua Green Uppers with a light Peppermint fragrance. Kemdent Light Cure Trays, are the easy to use and cost effective alternative to traditional self-cure acrylic special tray materials.

The non-sticky material can be used to create fabrications of custom impression trays. It has an indefinite working time and at dough stage it is easy to adapt and trim. It does not slump and has minimum shrinkage even when forming a handle.

The real benefit is the excellent value for money, the material can be re-used therefore no wastage, plus due to its translucency, exact modelling on the surface of the custom impression tray can be achieved.

When curing under halogen and UVA light, Kemdent Light Cure trays become extremely rigid and dimensionally stable which eliminates the risk of hidden distortion during the impression taking procedure.

For further information on the Kemdent Light Cure Trays or to place an order ring 01793 770256. Email sales@kemdent.co.uk or visit our website www.kemdent.co.uk

ZIRKONZAHN: 3D VIRTUAL PATIENT REPRODUCTION AND THE RECREATION OF THE INDIVIDUAL AESTHETIC. ZIRKONZAHN NEW LECTURE TOURS IN THE UK w The human being is an aesthetic creature. Giving the patient his natural smile means recreating that perfect harmony of forms that is at the origin of one’s individual aesthetic. After the success of this year’s lecture tour, Zirkonzahn (South Tyrol, Italy), innovation driver for the dental sector, founded by MDT Enrico Steger – father of Prettau® zirconia and inventor of the Prettau® Bridge full contour restoration – will “open their doors” also in 2020 with a brand new lecture tour around the UK. The lectures, open to all dentists and dental technicians, aim at introducing new concepts to reproduce the patient’s natural aesthetic in a prosthetic restoration through modern digital technologies. To create highly aesthetic and 100% individual restorations, the notion of predictability and the 3D virtual reproduction of the patient face are core concepts for effective digital workflows. After a general presentation of Zirkonzahn, DT Sergio

Multifuctional, aesthetic mock-up created based on the 3D virtual patient reproduction

Polisi (Zirkonzahn CAD/CAM expert and worldwide lecturer) will explain innovative technologies for the digital acquisition of the patient’s oral situation and physiognomy, which can be captured and imported in the software in a 1:1 ratio – that is, with no loss of precious information. By showing real patient cases, DT Sergio Polisi will describe how the treatment team can improve patient satisfaction through workflows that enable a reduction of chair-side appointments and the realistic preview of the final prostheses, for 100% individual restorations. Within this framework, DT Sergio Polisi will focus on new 3D virtual face animation and articulation concepts for a faster design of implant-supported Toronto bridges.

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When it comes to aesthetic, also material choices play a relevant role. Sergio Polisi will present the latest innovations in terms of zirconia materials and will describe new techniques for creating ultra-thin, noninvasive zirconia veneers made with the new Prettau® materials. Participation is free but registration is obligatory. The first lecture tour will take place in Scotland from January 27th to 30th. For information and registration, please contact: E: carmen.ausserhofer@zirkonzahn.com T: +39 0474 066 662

COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE TRYCARE: KERATOR - WHY PAY MORE? w Trycare offer an extensive range of Laboratory problem solvers including the Kerator Overdenture Attachment System, which is available to fit all the most popular implant systems. What is more it is lower priced than any competitor! Supplied with a choice of straight or 15° angulation to make it easier to adapt to the aesthetic requirements of the patient, Kerator abutments have the lowest profile of any overdenture attachment (just 1.48mm) which means they are easier to place where space is at a premium. They are available with soft tissue cuff heights from 1 to 6mm. With a choice of retention levels, Kerator overdenture attachments provide excellent retention so that patients can enjoy the comfort and stability that will transform their lives. Other advantages include a plastic carrier that provides safer handling and easier placement, plus easier visual checking of the implant’s alignment. Dual-retention which enables increased retention as well as easier

pivoting in any direction. Self-alignment which automatically centres the male on the housing attachment, allowing patients to easily seat their overdenture. An extended range of male attachments which allows for insertion up to 40° of implant divergence. A 15° angled abutment which can be used to further extend the allowable divergence. A dual undercut metal housing design that provides sturdier retention within the denture acrylic.

Kerator is supplied in an all-in-one package that contains everything you need at an extremely competitive price. For more information about Kerator overdenture attachments please contact your local Trycare Representative: T: 01274 885544 W: www.trycare.co.uk/kerator

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